Balance in focus: a simple observational scale to monitor the effect of exercises on static balance in case of childhood flexible flat foot.
Gabriella Posa, Orsolya Betak, Edit Nagy
PMID 33281289WHAT IT FOUND
After 20 weeks of a combined foot and balance training intervention, navicular drop and heel-rise results improved in 19 children with flexible flat foot.
A new quality-based score showed better eyes-closed balance, while standard Berg scores did not change significantly.
Key findings
01After 20 weeks, the sit-to-stand navicular drop test improved significantly on both feet (p=0.01).
02Heel-rise repetitions for 30 seconds increased from 17.74 ± 0.65 to 34.21 ± 2.29 after training (p=0.0002).
03The new time vs quality observational static balance score quality domain improved significantly during eyes-closed tandem standing (p=0.02), while the Berg Tandem score did not change.
STILL TO COME
How it was doneWhat they foundWhat it means for PTs
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What it does not show
Only 19 children were studied, so the results are not generalisable to larger or different populations. There was no control group, so normal development over 20 weeks could have contributed to the changes. The intervention combined many exercises at once, so the contribution of any single component cannot be separated. The new observational score was not tested for inter-rater or intra-rater reliability or validity. Testing was done by a final-year physiotherapy student under supervision, and scoring of balance quality is subjective. Eyes-closed conditions were not blindfolded, and participants could open their eyes, which may affect performance.
Declared interests
There was no conflict of interest and the work was not funded.
The easy way to misread this
Do not conclude that the training caused the improvements: the study had no control group, only 19 children aged 9 to 14 who were still developing, and the intervention combined many exercises, so no single component can be credited. Do not use the new balance score as a validated measure, because its inter-rater and intra-rater reliability and validity were not tested.